We deal with a seemingly endless conveyor belt of fad quack remedies (the proverbial game of whack-a-mole). We always have some new nonsense to deal with. For this reason I occasionally will look back at the pseudosciences of yesterday to get an update on any relevant research.
It often takes years, even decades, for definitive clinical research to get done, long after the public’s attention span has waned and the charlatans have moved on to the next con. This means the snake oil peddlers get to make unjustified overhyped statements about their latest miracle remedy, and our response is often mostly that the plausibility is low and there currently is insufficient clinical evidence to recommend the treatment. Then, years later, when the clinical evidence is there, everyone has moved on. It’s an endless cycle.
So let’s take some time to look back and a couple of dubious treatments for COVID, see what people said at the time, and where the latest clinical evidence is – ivermectin and hydroxychloroquine (HCQ). You can just search our posts to see what we here at SBM had to say. For example, Scott Gavura started a series of posts – Ivermectin is the new hydroxychloroquine – in which he concluded (in 2021), “Similar to hydroxychloroquine, there is no convincing evidence that demonstrates ivermectin has any meaningful clinical effects in the treatment of COVID-19.” No one here recommended the use of either drug, which were just distractions from effective treatments.
What were the less credible sources saying at the time? RFK Jr. in an interview with Children’s Health Defense in December 2020 said, “if hydroxychloroquine works, which it does. And if Ivermectin works, which it definitely does, he legally can not get emergency use authorization for any vaccines, because if there’s an approved drug that works against you, you cannot get emergency use authorization. So he had to kill hydroxychloroquine. He had to kill Ivermectin.”
As an aside, I suggest you read the whole transcript (even though the formatting is terrible). It’s always informative to listen to someone like RFK speak when they think they are speaking to compatriots. The nonsense flows unobstructed. The interview is an endless stream of lies, distortions, and rank conspiracy mongering.
Also in 2021, Dr. Pierre Kory, a critical care specialist and co-founder of Frontline COVID-19 Critical Care Alliance, said, “Mountains of data have emerged from many centers and countries around the world showing the miraculous effectiveness of ivermectin, it basically obliterates transmission of this virus. If you take it, you will not get sick.”
In 2020 Dr. Vladimir “Zev” Zelenko said, “Any obstruction to life saving medication (HCQ) should be viewed has crimes against humanity.”
There are many more examples, but you get the idea. Promotion of both of these drugs were definitive, unqualified, and incredibly hyped. There were all all entirely wrong. Let’s take a look at the updated evidence, starting with ivermectin. The latest systematic review is from this year, 2026, which looks at a total of 40 RCTs involving 23,243. The found: “For prevention, there was no statistically significant difference between the ivermectin group and control group in SARS-CoV-2 infection rate [risk ratio (RR) 0.37; 95% Confidence Interval (CI) 0.12 to 1.20]. For treatment, all-cause mortality for both hospitalized patients (RR 0.94; 95%CI 0.74 to 1.20) and outpatients (RR 0.88; 95%CI 0.55 to 1.42) showed no statistically significant difference.” They then concluded that, “This meta-analysis provides evidence that ivermectin does not statistically significantly reduce the risk of SARS-CoV-2 infection or improve clinical outcomes in patients with COVID-19.”
This was the latest but not necessarily the best systematic review. Another review from 2025 was a bit more rigorous, because it assessed risk of bias, and stuck to randomize controlled clinical trials. They also found that ivermectin was not associated with any benefit for either treatment or prophylaxis.
Another 2025 review found, “ivermectin did not significantly influence critical clinical outcomes in COVID-19 patients.”
These outcomes are consistent with older reviews, which shows that additional, larger, more rigorous studies confirmed what the older studies showed – that ivermectin is simply not an effective treatment for COVID-19. It takes a lot of studies, however, to reach such conclusions. Treatments can be tested in different populations, in-patient vs out-patient, as treatment vs prophylaxis, and following different outcomes such as length of hospital stay, mortality, severity, and transmissibility. But no matter how you look at it – ivermectin simply does not work.
So why did RFK Jr. and so many others say that “it definitely does”? It’s just more evidence that RFK is not a scientist, not a doctor, not a critical thinker, and frankly does not know what he is talking about. He is a conspiracy theorist and his logic is biased and muddled. He has a consistently poor grasp on fine details, always in the direction that serves his narrative. Again – read the interview, it’s amazing.
What about hydroxychloroquine? The latest relevant review is from 2025, which looks as many treatments, and conclude in part, “Several interventions do not seem to result in a benefit for any patient important outcomes, including ACEi/ARB, aspirin, colchicine, fluvoxamine, hydroxychloroquine, ivermectin, and lopinavir-ritonavir.”
The most recent review of HCG specifically is from 2024, and found not benefit from HCG for any treatment outcome in COVID, and perhaps a small prophylactic benefit although with low confidence that should be “interpreted with caution”. So essentially, no clear benefit for prevention or treatment.
This is all in line with this Cochrane review from 2020, in which the data was already so definitively negative that Cochrane uncharacteristically concluded: “We do not think new studies of hydroxychloroquine should be started for treatment of COVID-19.”
So 5-6 years later updated systematic reviews of the additional clinical trials even more confidently conclude that both ivermectin and HCG are of no benefit for the prevention or treatment of COVID-19. I feel compelled to point out – this is not an isolated or cherry picked example. This is what we see over and over again. Those following a science-based medicine approach have a much greater success at predicting later research than those hyping miracle cures.
There is a reason for this. The whole idea behind SBM is to develop and constantly tweak the best methods for predicting the probability that any intervention will be safe and effective, based upon a detailed inference from all available scientific evidence. What this simply means is that science works, but you have to look at the scientific evidence in a rigorous and unbiased way. There’s the rub.
